A 6-year-old child recovers from pneumococcal meningitis treated with ceftriaxone and dexamethasone. Before discharge the parents ask about long-term complications. The most important investigation to perform at discharge or within 6 weeks to detect the most common neurological sequela is:

• A MRI brain with contrast
• B CT head without contrast
• C EEG
• D Brainstem auditory evoked response (BAER) ✓

Explanation

Sensorineural hearing loss is the most common neurological sequela of bacterial meningitis, occurring in up to 30 percent of pneumococcal cases. All children should undergo hearing assessment, preferably BAER, before discharge or within 4 to 6 weeks. Streptococcus pneumoniae and Haemophilus influenzae carry the highest risk. Early detection allows timely cochlear implant evaluation.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.